Impact of p16 status on pro- and anti-angiogenesis factors in head and neck cancers.

BACKGROUND: Head and neck cancers (HNC) are aggressive tumours. Overexpression of p16 in HNC correlates with human papilloma virus (HPV)-associated HNC that carry a better prognosis than HPV-negative tumours. Angiogenesis is an important factor in tumour progression. Our aim was to dissect the impact of p16 expression on angiogenesis factors in HNC. METHODS: Eighteen newly diagnosed HNC patients and controls were analysed. Eleven pro- and anti-angiogenesis factors were quantified using multiplex ELISA in HNC patients and controls. Angiogenesis factors were analysed in tumour tissue using immunohistochemistry. RESULTS: Circulating levels of endostatin (anti-angiogenesis factor) were higher in the HNC group compared with healthy donors. Interestingly, the pro-angiogenesis factors angiopoietin-1 and vascular endothelial growth factor (VEGF) were significantly higher in patients with p16-negative compared with p16-positive HNC. Moreover, the major source of VEGF in p16-positive HNC tissue was tumour stromal cells. In contrast, both tumour cells and stromal cells expressed VEGF in p16-negative tissue. CONCLUSIONS: We show that p16-negative tumours associate with increased circulating levels of pro-angiogenic VEGF and angiopoietin-1. Tissue expression of VEGF differs between p16-positive and p16-negative tumours. These findings may explain differences in the biological behaviour of p16-positive and p16-negative HNC. Better understanding of mechanisms by which the p16 status influences tumour angiogenesis may guide the development of targeted therapies.

A report on quality-of-life outcomes following transmastoid plugging of superior semicircular canal dehiscence in a newly established service in a UK hospital.

OBJECTIVE: This study aimed to evaluate the quality-of-life outcomes following transmastoid plugging of semicircular canal dehiscence in a newly established service in a UK hospital. METHOD: Quality-of-life outcomes were measured using the Glasgow benefit Inventory score in three patients who underwent transmastoid plugging for superior semicircular canal dehiscence between September 2019 and March 2020. Patients also completed pre- and post-operative symptomatic questionnaires and vestibular-evoked myogenic potential testing. RESULTS: All three patients reported an improvement in overall quality-of-life outcomes with a mean overall Glasgow Benefit Inventory score of +37 (range, +22.2-66.6). There were no immediate post-operative complications and hearing was preserved in all patients. CONCLUSION: This study reported an initial successful experience with transmastoid plugging of superior semicircular canal dehiscence. In all patients, improvement in quality-of-life measures and symptoms was reported.

A Study of the Safety and Morbidity Profile of Closed versus Open Technique of Laparoscopic Primary Peritoneal Access Port in Patients Undergoing Routine Laparoscopic Cholecystectomy at a Tertiary Care Hospital in Northeastern India.

Introduction: Laparoscopic cholecystectomy (LC) is the gold standard operation for gallstone disease. Primary port placement into the abdomen is a blind procedure and is challenging with chances of unforeseen complications. The complication rate has remained the same during the past 25 years. Both closed/Veress and open/Hasson's techniques are commonly employed and have their typical indications for use. Materials and Methods: This prospective study was carried out in the Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, from January 2014 to January 2016, with the aim to compare the safety profile of closed/Veress and open/Hasson's methods of access to the abdomen during laparoscopic cholecystectomy (LC). The study had 400 eligible cases undergoing LC who were randomly allotted into 2 groups with 200 cases each: group A: closed/Veress needle method and group B: open/Hasson's method. Results: Closed/Veress and open/Hasson's method of establishing pneumoperitoneum in laparoscopic cholecystectomy is equally safe in terms of major complications. The closed/Veress method gives faster access to the abdomen as compared to the open method (5.62 ± 2.23 minutes and 7.18 ± 2.52 minutes, respectively, p value <0.0001). The open/Hasson's method is associated with more primary port site complications (9/200 vs. 0/200, p value 0.0036) and troublesome intraoperative gas leaks (39/200 vs. 2/200, p value <0.0001). The open technique for primary peritoneal access port for laparoscopic cholecystectomy does not impart any additional benefits in terms of safety and morbidity profile in patients undergoing LC. Conclusion: The closed/Veress method of establishing pneumoperitoneum in laparoscopic cholecystectomy is equally safe in terms of major complications and gives quicker access to the abdomen as compared to the open method.

Toxicological impact of deltamethrin on growth and nitrogen content of a rice field cyanobacterium Calothrix sp. (GUEco 1002).

Cyanobacteria are an important component in the rice field ecosystem and are a well known source of natural biofertilizer. Pesticidal application for the control of pests in rice field soil has led to several environmental problems, and poses a great threat to these beneficial microorganisms. Studies on the impact of pesticides on the diazotrophic growth and survivability of these microorganisms have recently gained much attention. The present paper describes the effects of an iterated use of the insecticide deltamethrin (2.8% EC) on the growth and nitrogen fixation capacity of the filamentous cyanobacterium Calothrix sp. (strain GUEco 1002). This organism has shown a varying degree of sensitivity to the insecticide. For evaluating the deltamethrin toxicity, the test organism was subjected to varying concentrations of deltamethrin i.e. 17.5 ppm, 35 ppm, 70 ppm and 140 ppm based upon LC50 for 20 days. The data obtained in the laboratory revealed that the treatment of the test organism with deltamethrin (17.5-140 ppm) negatively affected its growth, pigments, protein and nitrogen content in a time dose dependent manner. In contrast, carbohydrate content significantly increased with increasing concentrations of deltamethrin, this effect being more prominent at 140 ppm treatment (38%). At this high level (140 ppm), the test organism showed a significant decrease in dry weight biomass (46%), chlorophyll-a (72%), carotenoids (57%), phycocyanin (67%), protein (69%) and nitrogen content (61%) over the control. A little, but insignificant, stimulatory effect on nitrogen content was recorded at 17.5 ppm of the insecticide which however, was the opposite in the case of growth, pigments, carbohydrate and protein content.

The learning curve for endoscopic tympanoplasties: a single-institution experience, in Birmingham, UK.

OBJECTIVE: This study aimed to assess whether increasing operative experience results in better surgical outcomes in endoscopic middle-ear surgery. METHODS: A retrospective single-institution cohort study was performed. Patients underwent endoscopic tympanoplasty between May 2013 and April 2019 performed by the senior surgeon or a trainee surgeon under direct supervision from the senior surgeon. Following data collection, statistical analysis compared success rates between early (learning curve) surgical procedures and later (experienced) tympanoplasties. RESULTS: In total, 157 patients (86 male, 71 female), with a mean age of 41.6 years, were included. The patients were followed up for an average of 43.2 weeks. The overall primary closure rate was 90.0 per cent. CONCLUSION: This study demonstrates an early learning curve for endoscopic ear surgery that improves with surgical experience. Adoption of the endoscopic technique did not impair the success rates of tympanoplasty.

Phytoremediation of crude oil-contaminated soil employing Crotalaria pallida Aiton.

The purpose of the study was to evaluate the phytoremediation potentiality of a herb named Crotalaria pallida which are abundantly grown on crude oil-contaminated soil of oil field situated at upper Assam, India, so that this plant could be used to remediate hydrocarbon from contaminated soil. To evaluate the potentiality of the plant, a pot culture experiment was conducted taking 3 kg of rice field soil mixed with crude oil at a concentration of 10,000 (10 g/kg), 20,000 (20 g/kg), 30,000 (30 g/kg), 40,000 (40 g/kg), 50,000 (50 g/kg), 60,000 (60 g/kg), 70,000 (70 g/kg), 80,000 (80 g/kg), 90,000 (90 g/kg), and 100,000 (100 g/kg) ppm. Ten numbers of healthy seeds of C. pallida were sown in three pots of each concentration for germination, and after 15 days of germination, single healthy seedling in each pot was kept for the study. A control setup was also maintained without adding crude oil. The duration of the experiment was fixed for 6 months. The results showed that uptake of hydrocarbon by the plants was increased with increasing the concentration of crude oil in the soil up to 60,000 ppm. After that, uptake of hydrocarbon by the plants was found to be lower with increasing doses of crude oil concentration. Uptake of hydrocarbon by the shoot was found to be maximum, i.e., 35,018 ppm in 60,000 ppm concentration. Dissipation of total petroleum hydrocarbon (TPH) from the soil was also gradually increased with increasing concentration of crude oil in the soil up to 60,000 ppm. Maximum dissipation, i.e., 78.66 %, occurred in 60,000 ppm concentration of crude oil-mixed soil. The plant could not survive in 100,000 ppm concentration of crude oil-mixed soil. The results also demonstrated that there was a reduction in plant shoot and root biomass with an increase of crude oil concentration. Furthermore, results revealed that the shoot biomass was higher than root biomass in all the treatments.

Effect of lambda cyhalothrin on Calothrix sp. (GUEco 1001), an autochthonous cyanobacterium of rice fields of Brahmaputra floodplain.

Pesticide contamination in the rice fields has manifested into a serious global environmental concern. Application of pesticides in the rice fields has deleterious effects on non-target organisms including nitrogen-fixing cyanobacteria which help to maintain the rice field fertility. In the present research endeavor, the effect of lambda cyhalothrin (5% EC), a synthetic pyrethroid insecticide, has been studied on the growth and pigments content of Calothrix sp. (GUEco 1001), an indigenous strain isolated from rice grown areas of Brahmaputra floodplain. To study the toxic effect of lambda cyhalothrin, the test organism was exposed to varying concentrations of the insecticide i.e., 20 ppm, 40 ppm, 80 ppm, and 160 ppm based upon the determination of LC50 for a period of 20 days. The result obtained in the laboratory showed a progressive decrease in the growth and pigments content by the test organism with increasing concentrations of the lambda cyhalothrin against time dose-dependent manner. At high dose (160 ppm), the test organism showed significant decrease in dry weight biomass (54.5%), chlorophyll-a (68%), carotenoids (38%), phycocyanin (80%), and nitrogen contents (55%) over the control. A little but insignificant stimulatory effect on growth and chlorophyll-a contents was recorded in 20 ppm treatment of the insecticide that, however, was reversed in case of carotenoids and phycocyanin contents.

Sphenoid sinus tuberculosis in children-a rare entity.

Tuberculosis involving the sphenoid sinus is an unusual entity. Two cases of sphenoid tuberculosis in the pediatric age group are described along with a review of literature. In both cases, MRI was performed for radiological assessment followed by endoscopic biopsy to establish tissue diagnosis. The patients received antitubercular therapy and have shown good clinical response. Tuberculosis as a differential diagnosis of sphenoid lesions is to be kept in mind especially in tropical countries.

Rhinophycomycosis.

Rhinophycomycosis, a subcutaneous fungal infection, is less uncommon than many other frequently cited granulomatous lesions of the paranasal sinuses. Four illustrative cases are presented with their characteristic clinical, radiological and histopathological features. The initial origin of the swelling was always in the region of the nasal vestibule and ala. The therapeutic response to potassium iodide, ketaconazole and fluconazole was dramatic and sustained.

Laryngeal myxoma.

Myxoma is an uncommon neoplasm in the head and neck region. Laryngeal myxomas are rarer still. We report a case of a large myxoma in the supraglottis, that was excised endoscopically.

Unusual presentation of cervical spine metastases to the ENT surgeon.

OBJECTIVE: Cervical spine metastases account for 10 per cent of all spinal metastases. We report three cases of cervical spine metastases whose unusual primary presentation was with ENT-related symptoms. METHODS: The three patients reported herein did not have a confirmed diagnosis of malignancy at presentation. The first patient presented with stridor, the second presented with dysphagia and the third presented with dysphonia. All patients complained of significant neck pain that preceded and was concomitant to the other symptoms. Clinical suspicion of cervical spine involvement led to radiological investigation with computed tomography, which showed metastatic lesions in the craniovertebral junction and cervical spine region. Histological confirmation of malignancy was obtained for two of the three patients. The condition proved uniformly fatal in the weeks following diagnosis. A review of the literature on this condition was conducted using PubMed and Medline databases. CONCLUSION: Cervical spine pathology may present initially to the ENT surgeon. A high degree of suspicion of cervical spine involvement should be maintained in elderly patients with persistent or progressive neck pain, with or without other ENT symptoms. Adequate radiological imaging will usually confirm the diagnosis.

Treatment algorithm for oral anticoagulant and antiplatelet therapy in epistaxis patients.

BACKGROUND AND OBJECTIVES: There is currently little published guidance on the management of anticoagulant and antiplatelet medication in patients admitted with epistaxis. The routine practice of withholding such medication in an attempt to control the epistaxis is common in the UK. However, this practice is not evidence-based, is often unnecessary, and can be associated with significant morbidity. This study introduces a treatment algorithm for oral anticoagulant and antiplatelet therapy in epistaxis patients, validated through a completed audit cycle. METHODS: One hundred patients admitted with epistaxis to the University Hospital Southampton NHS Foundation Trust were studied via a two-audit cycle covering the implementation of a new treatment algorithm formulated jointly by the otolaryngology and haematology departments. RESULTS: On admission, 58 per cent of patients were taking some form of anticoagulant or antiplatelet medication. The number of patients having such medication withheld decreased significantly between the two audits, for all drugs studied (i.e. aspirin, clopidogrel and warfarin). There was no significant increase in re-bleeding or re-admission rates between the audits. CONCLUSION: Implementation of this treatment algorithm would help standardise management for epistaxis patients taking anticoagulant or antiplatelet drugs, and should reduce morbidity associated with unnecessary routine discontinuation of such medication.

Effect of transplanting time on incidence of alternataria leaf blight in solanum khasianum clark.

Solanum khasi Clark is a shrub which yields solasodine, a steroidal alkaloid. Transplating of seedlings of S. khasianum during November was found to be favourable for development of Alternaria leaf blight followed by transplanting in December, January and February. This paper presents the findings of the investigation.